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J AM COLL SURGEONS：乳房重建术后，使用抗生素24小时足矣

2016-03-31 MedSci MedSci原创

乳房重建术抗生素伤口感染
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新的研究发现快速组织扩张乳房重建术后，使用抗生素24小时预防感染与更长时间的效果相当，并且不增加额外的感染并发症，研究发表在于3月3日 Journal of the American College of Surgeons.

新的研究发现快速组织扩张乳房重建术后，使用抗生素24小时预防感染与更长时间的效果相当，并且不增加额外的感染并发症，研究发表在于3月3日 Journal of the American College of Surgeons.

CDC现有的指南也推荐在TE-IBR后只使用24小时，但临床实践却不是这样。主要作者Brett T. Phillips医生来自北卡罗来纳州达勒姆杜克大学医学院,他和同事对112个TE-IBR病人进行了一项前瞻性非劣效性试验（180个乳房）。62个病人使用24小时抗生素后停止，50个病人使用抗生素直到引流管移除。

所有受试者都在术前根据体重指数（低于或高于30）使用1-2g 头孢唑林或若阿司匹林过敏则使用600-900mg的克林霉素。如果有必要的话，术中抗生素是在初次用药4-6小时后给予。所有受试者都接受了24小时的静脉注射，持续口服抗生素的给予500mg头孢氨苄，1天4次，或300mg的克林霉素1天3次。

24小时治疗组有12人发生手术部位感染，延长治疗组有11人（19.4% vs 22.0%）。延长治疗组有7人需要静脉抗生素，整体的植入物滑落有7人（14.0%）。24小时治疗组有4个病人需静脉抗生素，3个病人需重新植入假体(4.8%)。糖尿病病人，术后皮下血肿，或伤口裂开的病人更可能发生术后感染（P<0.02）。

作者提到了此实验的几点局限，包括他们的非劣效性研究设计妨碍了证明24小时治疗组的优势作用，由于经济和逻辑限制，缺乏安慰剂和双盲。

原始出处：

Brett T. Phillips, MD, Mitchell S. Fourman，et al,Are Prophylactic Postoperative Antibiotics Necessary for Immediate Breast Reconstruction? Results of a Prospective Randomized Clinical Trial,,J Am Coll Surg March 30, 2016



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  1. [GetPortalCommentsPageByObjectIdResponse(id=128606, encodeId=230612860670, content=不错哦，会学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Fri Sep 16 11:52:00 CST 2016, time=2016-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1725247, encodeId=7a761e2524749, content=<a href='/topic/show?id=e20b101402' target=_blank style='color:#2F92EE;'>#24小时#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1014, encryptionId=e20b101402, topicName=24小时)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=447433741908, createdName=chengjn, createdTime=Mon Oct 10 06:19:00 CST 2016, time=2016-10-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1783287, encodeId=61a31e8328719, content=<a href='/topic/show?id=f16a499652' target=_blank style='color:#2F92EE;'>#Coll#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4996, encryptionId=f16a499652, topicName=Coll)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=07f7192, createdName=waiwai3030, createdTime=Fri May 20 09:19:00 CST 2016, time=2016-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=75484, encodeId=bf23e548498, content=xuexike, beContent=null, objectType=article, channel=null, level=null, likeNumber=136, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/07/24/1d5475965cdc40d3133b065415eb11f2.jpg, createdBy=9c1c1689676, createdName=葫芦小金刚h, createdTime=Tue Apr 05 08:18:00 CST 2016, time=2016-04-05, status=1, ipAttribution=)]
    2016-09-16 1e10c84am36(暂无匿称)

    不错哦，会学到很多

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=128606, encodeId=230612860670, content=不错哦，会学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Fri Sep 16 11:52:00 CST 2016, time=2016-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1725247, encodeId=7a761e2524749, content=<a href='/topic/show?id=e20b101402' target=_blank style='color:#2F92EE;'>#24小时#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1014, encryptionId=e20b101402, topicName=24小时)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=447433741908, createdName=chengjn, createdTime=Mon Oct 10 06:19:00 CST 2016, time=2016-10-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1783287, encodeId=61a31e8328719, content=<a href='/topic/show?id=f16a499652' target=_blank style='color:#2F92EE;'>#Coll#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4996, encryptionId=f16a499652, topicName=Coll)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=07f7192, createdName=waiwai3030, createdTime=Fri May 20 09:19:00 CST 2016, time=2016-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=75484, encodeId=bf23e548498, content=xuexike, beContent=null, objectType=article, channel=null, level=null, likeNumber=136, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/07/24/1d5475965cdc40d3133b065415eb11f2.jpg, createdBy=9c1c1689676, createdName=葫芦小金刚h, createdTime=Tue Apr 05 08:18:00 CST 2016, time=2016-04-05, status=1, ipAttribution=)]
    2016-10-10 chengjn

    #24小时#

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=128606, encodeId=230612860670, content=不错哦，会学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Fri Sep 16 11:52:00 CST 2016, time=2016-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1725247, encodeId=7a761e2524749, content=<a href='/topic/show?id=e20b101402' target=_blank style='color:#2F92EE;'>#24小时#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1014, encryptionId=e20b101402, topicName=24小时)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=447433741908, createdName=chengjn, createdTime=Mon Oct 10 06:19:00 CST 2016, time=2016-10-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1783287, encodeId=61a31e8328719, content=<a href='/topic/show?id=f16a499652' target=_blank style='color:#2F92EE;'>#Coll#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4996, encryptionId=f16a499652, topicName=Coll)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=07f7192, createdName=waiwai3030, createdTime=Fri May 20 09:19:00 CST 2016, time=2016-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=75484, encodeId=bf23e548498, content=xuexike, beContent=null, objectType=article, channel=null, level=null, likeNumber=136, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/07/24/1d5475965cdc40d3133b065415eb11f2.jpg, createdBy=9c1c1689676, createdName=葫芦小金刚h, createdTime=Tue Apr 05 08:18:00 CST 2016, time=2016-04-05, status=1, ipAttribution=)]
    2016-05-20 waiwai3030

    #Coll#

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=128606, encodeId=230612860670, content=不错哦，会学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzdAIB7UwTkHt6fQkBP8ictliaXtc5gCUmYdAW1sAETC2nhO3q6YjRHkUibyOCtP8ibmXNObTyd63A076/0, createdBy=d4111948983, createdName=1e10c84am36(暂无匿称), createdTime=Fri Sep 16 11:52:00 CST 2016, time=2016-09-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1725247, encodeId=7a761e2524749, content=<a href='/topic/show?id=e20b101402' target=_blank style='color:#2F92EE;'>#24小时#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1014, encryptionId=e20b101402, topicName=24小时)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=447433741908, createdName=chengjn, createdTime=Mon Oct 10 06:19:00 CST 2016, time=2016-10-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1783287, encodeId=61a31e8328719, content=<a href='/topic/show?id=f16a499652' target=_blank style='color:#2F92EE;'>#Coll#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=4996, encryptionId=f16a499652, topicName=Coll)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=07f7192, createdName=waiwai3030, createdTime=Fri May 20 09:19:00 CST 2016, time=2016-05-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=75484, encodeId=bf23e548498, content=xuexike, beContent=null, objectType=article, channel=null, level=null, likeNumber=136, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/07/24/1d5475965cdc40d3133b065415eb11f2.jpg, createdBy=9c1c1689676, createdName=葫芦小金刚h, createdTime=Tue Apr 05 08:18:00 CST 2016, time=2016-04-05, status=1, ipAttribution=)]
    2016-04-05 葫芦小金刚h

    xuexike

    0